Paul Starr

Paul Starr is co-founder and co-editor of The American Prospect, and professor of sociology and public affairs at Princeton University. A winner of the Pulitzer Prize for General Nonfiction and the Bancroft Prize in American history, he is the author of eight books, including Entrenchment: Wealth, Power, and the Constitution of Democratic Societies (Yale University Press, May 2019).

This article appears in the Winter 2018 issue of The American Prospect magazine as part of a joint project with the Century Foundation on Health Reform 2020 . Subscribe here to The American Prospect . hc2020_logo-04_jpeg.jpg With the Trump era only a year old and its full impact on health policy as yet unclear, it may seem premature to discuss what ought to come next. But, driven by new enthusiasm among progressives for Bernie Sanders’s single-payer plan, the debate has already begun, and if the past is any indication, supporters of reform will turn to proposals long in gestation when they are finally able to act. When that time comes, Democrats don’t want to discover they have locked themselves into commitments on health care that they cannot fulfill, just as Donald Trump and Republicans did in 2016. Democrats are justifiably angry today about the Republican efforts to sabotage the Affordable Care Act and cut Medicaid that have put health care for millions of people in...

This article appears in the Fall 2017 issue of The American Prospect magazine. Subscribe here . Americans often look back to the mid-20th century as a time when the country was cohesive and unified, unlike today’s bitterly divided society. That image of mid-century America was always incomplete, but insofar as there was a culture of consensus, it was not a wholly spontaneous development. Much of the country’s leadership and national media from the 1930s through World War II and the early postwar years made concerted efforts to foster unity across social and religious lines in the face of threats from abroad and at home to America’s stability and survival. The United States is surely different today—the lines of cleavage have shifted, the media have fractured into separate worlds, and we have a president who acquired power with explicitly anti-immigrant and racist appeals. But the mid-20th century experience nonetheless offers instructive lessons for confronting...

Former FBI Director James Comey’s testimony may have seemed like a boon to Democrats, but it has another effect that has been little commented on: Donald Trump is now totally dependent on congressional Republicans to avoid impeachment and therefore has no choice but to be a cheerleader for their policies and to sign whatever legislation they send him. When Trump was nominated, many people accepted his own self-characterization as a disruptive force within the Republican Party. But the party itself had already moved toward more extreme positions, and Trump’s cabinet appointments, proposed budget, moves toward economic and environmental deregulation, and repudiation of the Paris climate accord have been largely in line with the radicalism that now prevails among congressional Republicans. But if there were any thought that Trump would defy the Republican majorities in Congress—insisting, for example, on a health-care bill that actually protected many of the people who...

The following article, which appears in the Spring 2017 issue of The American Prospect under the title “The Republican Health-Care Unraveling: Resist Now, Rebound Later,” went to press on Tuesday, March 21, before the Republicans gave up on their health-care bill and pulled it from a vote. But while the first section of the article is now moot (at least for the time being), the second part (“Blocking Trump’s Chaos Option”) and the third (“The Next Progressive Health Agenda”) are pertinent to what happens next. - P.S., March 24, 2017. Imagine if Donald Trump had been a genuine populist and followed through on his repeated promises to provide health insurance to everybody and take on the pharmaceutical and insurance industries. Populists in other countries have done similar things, and Trump might have consolidated support by emulating them. Of course, Trump’s promises about health care weren’t any more genuine than his promises...

This is the second part of a two-part article. Part I is here . The full version appears in the Spring 2017 issue of The American Prospect under the title: “The Republican Health-Care Unraveling: Resist Now, Rebound Later.” This is the “rebound” part. Subscribe here to the magazine. Even as they resist the Republican rollback of the ACA and Medicaid, Democrats should be thinking about new initiatives in health care. No doubt the next steps will depend in part on what Trump and the Republicans end up doing. In the wake of federal legislation, many of the critical decisions in the short run may move to the states. But Democrats cannot limit themselves to defensive efforts to salvage the ACA at either the federal or the state level. They need to think about a more attractive national agenda in health care that reflects the lessons of the ACA and new political realities. The coming national Democratic debate is going to focus on extending Medicare—to whom,...